WASHINGTON—President
Trump
continued to reach out to Republican lawmakers Thursday to take the lead on crafting a health plan to replace the Affordable Care Act, working to hand off the politically sensitive effort ahead of the 2020 elections.

Senate Republicans, meanwhile, want the administration to take the lead on developing a plan while they remain on politically safer ground, working on popular voter issues such as lowering drug prices and ending surprise medical bills.

“He’s sort of charging us and we’re charging him to find solutions,”
Sen. Shelley Moore Capito
(R., W.Va.) said Thursday.

The standoff means there is no clear path to a GOP health plan, or certainty that a replacement to the ACA will be crafted, a sign of just how sensitive the issue has become for Republicans still stinging over voter backlash against their attempt to repeal the health law.

While taking questions in the Oval Office beside the wife of Venezuelan opposition leader Juan Guaido, President Trump blasted the Affordable Care Act, saying it is “too expensive for the people.” Photo: EPA

Rep. Mark Meadows
(R., N.C.), chairman of the conservative House Freedom Caucus, told reporters Thursday that the White House had suggested to him that congressional Republicans should be pulling together health legislation.

“I’ve had a number of conversations in the last 24 hours with the administration about potential plans,” he said. “It’s my impression that there will be a plan that the president and the White House endorses, but I think it will be a collaborative effort between House and Senate Republicans and hopefully some House and Senate Democrats to come up with that plan.”

Mr. Trump spoke with
Sen. John Barrasso
(R., Wyo.) about health care on Wednesday, according to Mr. Barrasso, a physician who has worked on health legislation.

Mr. Trump said Thursday he has asked a small group of senators, including Mr. Barrasso,
Sen. Bill Cassidy
(R., La.) and
Sen. Rick Scott
(R., Fla.), to come up with a “spectacular” health-care plan. He said a plan is being worked on “now,” but added: “There’s no very great rush from the standpoint that we’re waiting for the decisions from the court.”

“If we win on the termination of
Obama
care, we will have a plan that’s far better than Obamacare,” he said.

Seema Verma,
head of the federal Centers for Medicare and Medicaid Services, said in November that the administration had “contingency plans” if a judge were to strike down all or part of the health law, but no plans have been made public.

Marc Short, chief of staff for Vice President
Mike Pence,
said this week that an administration plan would be released in coming months. It is unclear what it could contain. Mr. Trump’s 2020 budget request calls for funneling ACA funding to the states in the form of block grants that states would use to fashion their own health markets.

At the same time, the president has been talking to GOP lawmakers about legislation they could pass.

“I assume the president wouldn’t have brought this up if there wasn’t a White House proposal coming,”
Sen. Roy Blunt
(R., Mo.) said Thursday. When asked how eager Senate Majority Leader Mitch McConnell (R., Ky.) was to dive back into health care, Mr. Blunt said, “he’s also waiting for the White House proposal.”

Mr. Meadows said one proposal he was reviewing was a plan from Republican health-care expert
Avik Roy,
components of which have been folded into legislation from
Rep. Bruce Westerman
(R., Ark.).

“That would provide a safety net for people up to 350% of poverty and allow the free markets to continue to work above that point. That may be a happy medium where we could get some bipartisan support,” he said. As of Thursday, the bill had no Democratic co-sponsors.

Mr. Trump has said he wants any plan to provide coverage protections for people with pre-existing conditions, a key and politically popular provision of Mr. Obama’s health act.

Conservative ideas have included expanding health savings accounts to a national pool of funds to help cover people with high-cost medical conditions. Senate Republicans believe the White House has to show what policies Mr. Trump would support before they move forward on a bigger proposal, Senate GOP aides said.

Republicans also feel they have time. The lawsuit over the health law is pending before the Fifth U.S. Circuit Court of Appeals in New Orleans, where the parties are in the middle of submitting written legal arguments.

Democratic-led states defending the ACA filed their brief this week, and the Republican challengers, as well at the Justice Department, are due to file their papers next month. An eventual Fifth Circuit ruling will likely take several months, and if the case goes to the Supreme Court, the litigation could last well into 2020.

The health law remains in place while the case continues.

Senate Minority Leader
Chuck Schumer
(D., N.Y.) on Thursday taunted Republicans, pointing out that neither the White House nor the party has an alternative should the Trump administration be successful in getting the 2010 health law invalidated.

“Well, I say, ‘God help the middle class,’” he said. “What, dare I ask, is their plan?”

House Speaker
Nancy Pelosi
(D., Calif.) on Thursday said the president hadn’t reached out to talk about health-care legislation, but they had spoken in the past about bills to lower prescription drug prices.

“The Republicans said during the campaign that they support the pre-existing condition benefit...so I assume they would honor that when that piece of legislation comes forward,” she said.

Mrs. Pelosi’s spokesman said she hasn’t spoken with Mr. Trump since March 14.